Dynamic changes in serum albumin and ferritin indicate higher risk of early-onset peritonitis in peritoneal dialysis patients.

Introduction: The objective of this study is to investigate the dynamic changes in serum albumin and ferritin as potential predictors for early-onset peritoneal dialysis-related peritonitis (PDRP) in patients undergoing peritoneal dialysis (PD).

Methods: This retrospective study included 215 patients with end-stage renal disease who initiated PD at Huadong Hospital. Patients were followed up to 24 months, during which episodes of PDRP were recorded. The dynamic changes in serum albumin and ferritin levels were evaluated within the first 6 months of PD initiation. Data were analyzed to assess the relationship between these biomarkers and early-onset PDRP.

Results: Among the 215 patients, 33.49% developed PDRP, and 28.93% experienced early-onset PDRP. Patients with lower baseline serum albumin levels (<35 g/L) and higher baseline ferritin levels (≥400 μg/L) had an increased risk of developing early-onset PDRP. Importantly, the risk associated with low initial albumin was not significant when serum albumin levels remained stable within the first 6 months (-5% to 5% change). Similarly, although higher baseline ferritin was associated with a higher risk of early-onset PDRP, patients with fluctuating ferritin levels (more than 35% change) showed no significant increase in the risk. Kaplan-Meier analysis revealed a lower cumulative technical survival rate in patients with early-onset PDRP.

Conclusion: Dynamic changes in serum albumin and ferritin levels within the first 6 months of PD can serve as significant predictors of early-onset PDRP, but stable levels of these markers mitigate their predictive value. Close monitoring of these biomarkers may help in identifying high-risk patients and improving PD outcomes.